护理专业学生艾滋病KAP的健康教育效果分析

目的 了解山东省某高校护理专业不同年级学生艾滋病健康教育前后艾滋病知识、态度及相关行为(knowledge,attitude,practice KAP)情况,为学校乃至社会更好开展艾滋病健康教育提供依据.方法 自行编写调查问卷,采用整群抽样的方法,对护理专业一年级、三年级的学生在艾滋病健康教育前后分别进行问卷调查.结果 护理专业一年级学生对艾滋病KAP在健康教育前后差异有统计学意义,教育效果明显(P＜ 0.05).健康教育后一年级、三年级学生对比效果差异有统计学意义(P 0.05).结论 经过连续、动态和多种形式的专业健康教育后,学生能进一步加强对艾滋病的主要传播途经和非传播途径等知识的掌握,对ADIS患者的态度改善,对以后从事该类病人的护理工作意愿逐步增强.但三年级经健康教育后部分学生对艾滋病病人的恐惧、甚至歧视的态度依旧不容乐观.     

Effect of a Simple Exercise Program on Hospitalization-Associated Disability in Older Patients: A Randomized Controlled Trial

ObjectiveHospitalization-associated disability [HAD, ie, the loss of ability to perform ≥1 basic activities of daily living (ADLs) independently at discharge] is a frequent condition among older patients. The present study assessed whether a simple inpatient exercise program decreases HAD incidence in acutely hospitalized very old patients.DesignIn this randomized controlled trial (Activity in Geriatric Acute Care) participants were assigned to a control or intervention group and were assessed at baseline, admission, discharge, and 3 months thereafter.Setting and ParticipantsIn total, 268 patients (mean age 88 years, range 75–102) admitted to an acute care for older patients unit of a public hospital were randomized to a control (n = 125) or intervention (exercise) group (n = 143).MethodsBoth groups received usual care, and patients in the intervention group also performed simple supervised exercises (walking and rising from a chair, for a total duration of ∼20 minutes/day). We measured ADL function (Katz index) and incident HAD at discharge and after 3 months (primary outcome) and Short Physical Performance Battery, ambulatory capacity, number of falls, rehospitalization, and death during a 3-month follow-up (secondary outcomes).ResultsMedian duration of hospitalization was 7 days (interquartile range 4 days). The intervention group had a lower risk of HAD with reference to both baseline [odds ratio (OR) 0.36; 95% confidence interval (CI) 0.17–0.76, P = .007] and admission (OR 0.29; 95% CI 0.10–0.89, P = .030). A trend toward an improved ADL function at discharge vs admission was found in the intervention group compared with controls (OR 0.32; 95% CI ‒0.04 to 0.68; P = .083). No between-group differences were noted for the other endpoints (all P > .05).Conclusion and ImplicationsA simple inpatient exercise program decreases risk of HAD in acutely hospitalized, very old patients.     

阿柏西普对葡萄膜黑色素瘤细胞的作用及其机制研究

目的 探索阿柏西普对葡萄膜黑色素瘤细胞的作用及其机制.方法 将B16F10细胞(葡萄膜黑色素瘤细胞)分为实验组和对照组,对照组不使用药物处理,实验组分别用0.2 g·L-1、2.0 g·L-1、4.0 g·L-1阿柏西普进行干预.通过实时细胞电子分析系统(RT-CES)、CCK-8法探讨不同剂量的阿柏西普对葡萄膜黑色素...     

基于Bevilacqua模型的乳腺癌保乳术患者术后淋巴水肿风险预测的临床研究

目的验证Bevilacqua乳腺癌术后淋巴水肿风险预测模型的临床适用性及可行性。方法回顾性分析2010年1月至2015年12月203例乳腺癌患者临床资料,临床数据分析使用统计学软件SPSS 24.0。Cox回归模型分析乳腺癌患者术后发生上肢淋巴水肿的危险因素,以P<0.05为有统计学意义;绘制ROC曲线,以曲线下面积检验模型预测效果;应用Hosmere-Lemeshow检验评估预测值与实际值的校准程度,以P>0.05为预测模型校准能力较好,预测与实际没有区别。结果所有患者随访共计62~86个月,中位随访时间70个月。术后5年内共发生上肢淋巴水肿患者45例(22.2%)。Cox回归模型分析结果显示,高身体质量指数(BMI)、接受过新辅助化疗、全腋窝淋巴结清扫、接受过放疗是上肢淋巴水肿的独立危险因素。Becilacqua上肢淋巴水肿风险预测模型ROC曲线分析结果显示,模型AUC值为0.711,95%CI(0.651~0.760),有较好的的预测效果。Hosmer-Lemeshow检验结果显示,风险预测模型预测风险与实际无明显差异(P=0.262),校准能力较好,与实际差别不大。结论Bevilacqua术后6个月淋巴水肿风险预测模型的准确性及适用性较高,可用于临床对乳腺癌保乳术后淋巴水肿的预测,可为预防淋巴水肿的发生制定干预决策提供参考。     

锁定钢板治疗肱骨近端骨折

目的评价锁定钢板治疗肱骨近端骨折的效果。方法应用锁定钢板治疗肱骨近端骨折患者35例：Neer分型二部分骨折11例,三部分骨折14例,四部分骨折10例。均采用Constant评分方法评价疗效。结果患者均获随访,时间为10～35个月。无内固定失败,骨折均愈合。肩关节功能评价：优6例,良22例,差7例。结论锁定钢板治疗肱骨近端骨折手术创伤小,疗效满意。     

CXCR5+ CD8+ T cells could induce the death of tumor cells in HBV-related hepatocellular carcinoma

The follicular CXCR5⁺ CD8⁺ T cells have recently emerged as a critical cell type in mediating peripheral tolerance as well as antiviral immune responses during chronic infections. In this study, we investigated the function of CXCR5⁺ CD8⁺ T cells in HBV-related hepatocellular carcinoma patients. Compared to CXCR5⁻ CD8⁺ T cells, CXCR5⁺ CD8⁺ T cells presented elevated PD-1 expression but reduced Tim-3 and CTLA-4 expression. Upon anti-CD3/CD28 stimulation, CXCR5⁺ CD8⁺ T cells demonstrated higher proliferation potency than CXCR5⁻ CD8⁺ T cells, especially after PD-1 blockade. CXCR5⁺ CD8⁺ T cells also demonstrated significantly higher granzyme B synthesis and release, as well as higher level of degranulation. Tumor cells were more readily eliminated by CXCR5⁺ CD8⁺ T cells than by CXCR5⁻ CD8⁺ T cells. Interestingly, we found that B cells were more resistant to CXCR5⁺ CD8⁺ T cell-mediated killing than tumor cells, possibly through IL-10-mediated protection. In addition, the CXCR5⁺ CD8⁺ T cell-mediated cytotoxic effects on tumor cells could be significantly enhanced by PD-L1 blockade. Together, we presented that in patients with in HBV-related hepatocellular carcinoma, CXCR5⁺ CD8⁺ T cells could mediate tumor cell death more potently than the CXCR5⁻ CD8⁺ T cells in vitro while the autologous B cells were protected.     

腮腺良性肿瘤手术中面神经颈支的解剖

目的探讨应用面神经颈支为向导显露面神经并完成腮腺良性肿瘤切除的可行性和安全性。方法收治腮腺良性肿瘤87例,分别应用以面神经总干、颊支、下颔缘支和颈支为向导的方法显露出面神经,完成腮腺肿瘤切除,并观察术后面神经的功能情况。结果应用面神经总干、颊支、下颔缘支和颈支显露面神经的病例分别为10、8、28、41例,术后出现的面神经损伤率依次为30％、37．5％、46,4％、24．3％,其中应用下颔缘支和颈支的方法术后面神经损伤几率的比较,P〈0.05,有显著差异性。结论应用面神经颈支为向导显露面神经总干及其他分支的方法,方便可行,优于通过下颔缘支的方法。     

临沂市农村儿童蛲虫感染状况分析

2006～2008年山东省土源性线虫监测资料中3～12岁293名农村地区儿童蛲虫总感染率为8．87％。其中男童感染率为9．52％，女童为8．00％，差异无统计学意义；幼托儿童感染率为17．33％，散居儿童和小学生感染率分别为6．67％和5．91％。     

临床医学专业学生从医职业心理准备调查分析

目的 探讨临床医学专业学生从医职业心理准备状况.方法 随机抽取792名临床医学专业新生,就医学生的人文素质要求、对病人的尊重、与病人的关系、择业原因、职业风险、工作责任等项目进行调查.结果 95％的学生选择医学生应该有“较高”及“非常高”的人文素质；96％的选择对病人“较尊重”和“特别尊重”；86％的选择与病人的关系“高于一般关系”和“生命之托关系”；72％的学生因为“职业神圣”而择业；98％的认为医学职业有风险和高风险；95％的认为工作责任较大和重大；认为“较辛苦”和“很辛苦”者占88％；仅6％的学生认为“收入大于付出”.结论 大多数学生对从医职业在人文素质、工作责任、职业风险、与病人的关系以及对病人的尊重等方面均有比较充分的心理准备,少数学生在这些方面的心理准备不足,增加这些方面的教育教学内容,提高学生的认识,是医学教育所需,这对于提高教学质量,构建和谐社会具有积极意义.     

CD44V6在子宫内膜异位症中的表达及意义

目的检测CD44V6在子宫内膜异位症在位、异位内膜与正常内膜中的表达,研究CD44V6在子宫内膜异位症发病中的作用.方法采用免疫组化方法对20例卵巢子宫内膜异位囊肿在位内膜、异位内膜与15例正常子宫内膜中CD44V6的表达进行检测.结果 CD44V6在卵巢子宫内膜异位囊肿异位内膜中的表达显著高于同期在位内膜与正常内膜的表达(P＜0.01),在位内膜与正常子宫内膜中CD44V6表达无显著性差异(P＞0.05).结论粘附分子CD44V6高表达在子宫内膜异位症发生发展中起重要作用.